| Show Using Ambulatory Care Sensitive Hospitalization Rates in Utah Denise Wong MSPH Marlene Egger Ph George White Jr MSPH Ph by age but not sex until after the 2000 Introduction Pooled rates were census Paoli 1999 The Utah Department of Health DOH available for two three or four-year Hospital Discharge Data HDD reporting intervals andlink to population estimates system and its successors are landmark was also provided However age-adjusted computer resources for the assessment of rates are still not available for children or the public health in Utah The Utah HDD elderly When requested MatCHIIM returs reporting system was one of the first of its zeroes as an indication of an invalid query kind with multiple uses including calculation of Ambulatory Care Sensitive Hospitalization Age and Sex Adjusted Rates ACSH rates are rates ACSH Calculating age and sex adjusted ASCH hospitalizations which are thought to be rates is key to their use aswarning flag of preventable if adequate primary care is barriers to primary care Some conditions received in time Millman 1993 ACSH apply to only one sex Without age rates are typically elevated relative to adjustment county withlarge elderly statewide rates in areas of low population may erroneously appear to have socioeconomic status Billings et al 1993 an elevated pneumonia hospitalization rate ruralfirontier areas Silver Babitz Magill orcounty withlarge infant population 1997 areas with higher uninsurance may erroneously appear to havehigher Grumbach 1995 Stewart et al 1997 and dehydration hospitalization rate than other areas with other access barriers to primary Even within subpopulations counties care Bindman et al 1995 Komaromy 1996 small area may have more infants than other Parchman Culler 1994 Local health small areas but comparable numbers of departments or others could use elevated teenagers or more old elderly 85 than ACSH rates in small areas aswamning flag other areas potentially causing confounding of locally inadequate access to primary care if age adjustment is omitted The Utah DOH has published two reports on ACSH rates for local health districts and for Users may query the HDD for age and sex other geographic small areas Bureau of adjusted rates for the entire population Surveillance and Analysis 1997 Bureau of Requesting age and sex adjusted ACSH Surveillance and Analysis 1998 rates insubgroup such as women only or elderly only will produce incorrect rates and The DOHworking continuously to improve the HDD reporting system does not the quality of these data resources The generate an invalid query waming TableMatemal and Child Health Information for diabetes an example shows Internet-Query Module MatCHIIM was the hospitalizations in the elderly The HDD second generation reporting system and it calculates crude rates correctly in population has considerable advantages over the HDD MatCHIIM also retums subgroups system in reporting rates for matemal and inaccurate crude rates for these subgroups child health Rolfs 1995 Further upgrades in such reporting systems are planned Suggestions for future upgrades Shah personal communication May 22 Despite the numerous beneficial uses of the 2000 The new user of these systems Utah HDD some additional features would should be altered to some of the features make these systems more user-friendly which may be judiciously used to obtain age First the denominator labels for rates could and sex adjusted rates be changed form per ten-thousand to per ten-thousand per year Second the options The reporting system was upgraded for the for age and sex adjustment could be more user-friendly MatCHIIM and HDD data expanded five-year age groups as well as MatCHIIM can be routed through it specialized age groups within children and provided an age-adjusted rate for diabetes elderly subgroups might be available Third mellitus when the user selected the adult the standard population should have Since the new population 18-65 US2000 as an option Fourth providing an standard population estimates are available 146 Digital image 2005 Marriott Library University of Utah Al rights reserved |
